Healthcare Provider Details

I. General information

NPI: 1174968812
Provider Name (Legal Business Name): DIXON KEITH JOYNER DVM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1233 W WARNER RD
CHANDLER AZ
85224-2771
US

IV. Provider business mailing address

1233 W WARNER RD
CHANDLER AZ
85224-2771
US

V. Phone/Fax

Practice location:
  • Phone: 480-857-0451
  • Fax: 480-963-6650
Mailing address:
  • Phone: 480-857-0451
  • Fax: 480-963-6650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number1766
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: